6 Golimumab (Simponi) Interactions You Should Know About

Golimumab (Simponi, Simponi Aria) is a monoclonal antibody medication that helps manage problematic inflammation in your joints and gut. It works by blocking an inflammatory protein called tumor necrosis factor, which is elevated when you have certain conditions such as rheumatoid arthritis (RA) or psoriatic arthritis (PsA).

If your healthcare provider includes golimumab in your treatment plan, you’ll receive an injection of the medication every few weeks. Golimumab is available under two brand names: Simponi, which is injected under the skin, and Simponi Aria, which is delivered through an IV. 

No matter how it's injected, golimumab can interact with several medications and vaccines. Some interactions are mild, but others can lead to serious side effects. Six of the top golimumab interactions to watch out for are described below.

Promotion disclosure

Simponi

Avg retail price

$6557.42(Save Free%)

GoodRx discount

$6557.42

See all discounts

How it works

Use GoodRx to find medications, pharmacies, and discounts.

GoodRx discounts can help you pay less for your prescription.

Bring your free coupon or savings card to the pharmacy.

1. Methotrexate

Golimumab interacts with methotrexate (Trexall), another RA medication. But this interaction isn’t actually a bad one. The two are used together to treat conditions like RA, PsA, and ankylosing spondylitis because of their interaction.

In clinical studies of people living with RA, methotrexate lowered the rate at which golimumab left the body by about 9%. Health experts believe this helps boost golimumbab’s effectiveness. Another study also showed that methotrexate helps golimumab that’s delivered by IV work better and longer.

If you have a condition like RA and receive a prescription for golimumab, there’s a good chance you’ll also receive a prescription for methotrexate (if you’re not taking it already).

2. Biologic medications

Biologics are complex medications that come from living organisms. Golimumab itself is a biologic. However, it generally isn’t safe to take other biologic medications used for autoimmune conditions while you’re taking golimumab. 

Many biologics work by suppressing (weakening) the immune system. If you combine golimumab with other biologic medications, you likely won’t get any additional benefits and the effects on your immune system can become too intense. This raises your risk of catching infections, some of which can become serious or life-threatening. 

Common examples of biologic medications to avoid while taking golimumab include:

• Abatacept (Orencia)

• Anakinra (Kineret)

• Rituximab (Rituxan)

• Tocilizumab (Actemra)

• Infliximab (Remicade)

• Adalimumab (Humira)

• Etanercept (Enbrel)

• Certolizumab (Cimzia)

Before starting golimumab, let your healthcare provider know if you’re already taking a biologic medication.

3. Warfarin

Warfarin (Coumadin, Jantoven) is an anticoagulant (blood thinner) that prevents and treats blood clots. If you take warfarin, you already know that various medications and foods affect how well it works.

Golimumab is one of these medications. It can cause your body to produce more of the enzymes (proteins) that metabolize warfarin. This can affect warfarin's ability to keep your blood from clotting too much or too little.

This effect is more serious when you’re first starting treatment with golimumab or have just stopped taking it. If your body is already used to warfarin, starting or stopping golimumab can disrupt your current warfarin balance. Your healthcare provider will likely check your warfarin levels more often if you make any changes to your golimumab routine.

4. Cyclosporine

Cyclosporine (Sandimmune, Neoral) is a medication that’s taken after organ transplant surgery to prevent organ rejection. In order for cyclosporine to work effectively, the amount of the drug in your body needs to stay within a tight range. If you’re taking cyclosporine, you’ll need to have frequent blood tests to make sure your levels aren’t too high or low.

Golimumab makes it harder to keep your cyclosporine levels where they should be. This is because golimumab can affect how your liver breaks down cyclosporine. This can hamper its effectiveness or make it more likely that you’ll experience side effects like high blood pressure, shakiness, or kidney problems.

As with warfarin, this interaction is more of an issue when starting or stopping golimumab. It’s not as concerning once your body is used to both medications.

5. Other narrow therapeutic index medications

Warfarin and cyclosporine are narrow therapeutic index (NTI) medications. These medications are very sensitive. A slight change in dose or blood concentration can significantly affect their tolerability and/or effectiveness. Golimumab can affect how your body breaks down a number of NTI medications.

If you’re combining golimumab with an NTI medication, your healthcare provider will be an essential resource. They’ll want to check your blood work more often to make sure the medications are working as they should.

Top examples of other relevant NTI medications are:

• Digoxin (Lanoxin)

• Theophylline (Theo-24)

• Carbamazepine (Tegretol)

• Lithium (Lithobid)

• Phenytoin (Dilantin, Phenytek)

• Phenobarbital

6. Live vaccines

It's a good idea to avoid live vaccines while you’re taking golimumab. Live vaccines contain weakened versions of living viruses or bacteria. If your immune system is weaker than normal because of medications like golimumab, there’s a chance the vaccine could trigger the infection it's meant to prevent.

Examples of live vaccines include:

• FluMist nasal spray flu vaccine

• Measles, mumps, and rubella (MMR) vaccine

• Chicken pox (varicella) vaccine

• Polio vaccine

• Tuberculosis vaccine (BGG)

• Typhoid vaccine

Keep in mind: You can still safely receive inactivated (non-live) vaccines while golimumab is in your system. These include the flu shot, COVID-19 vaccines, and many others. 

Live vaccines and pregnancy

If you take golimumab during pregnancy, let your baby's healthcare provider know before your baby receives any vaccines. Your baby should not receive live vaccines until at least 6 months have passed since your last golimumab dose during pregnancy. Your baby will be at a higher risk for infection if they receive a live vaccine during this time.

When should I contact my healthcare provider about a golimumab interaction?

You should talk to your healthcare provider about potential interactions before you start taking golimumab. When possible, it’s easiest and safest to prevent golimumab interactions in advance.

Make sure to share an up-to-date list of your over-the-counter and prescription medications with your entire healthcare team — especially your pharmacist and healthcare provider. This will help them screen for interactions that could be dangerous.

Communication throughout your treatment is also important. If you’re experiencing any side effects that you think are related to a golimumab interaction, you should contact your healthcare provider right away.

Why trust our experts?

Written by:

Sonja Jacobsen, PharmD, BCPS, BCOP

Sonja Jacobsen, PharmD, BCPS, BCOP,  is a clinical oncology pharmacy specialist currently practicing in Seattle. She has been practicing as a pharmacist since 2015 and is licensed to practice in Washington state and North Carolina.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Our editorial standards

Meet our experts